HomeMy WebLinkAboutWPO202100004 Application 2022-09-27Virginia Stormwater Management Program (VSMP)
Application for Albemarle County
Project Name:
Southwood Redevelopment - Blocks 9-11
(The name should he the same as it appears on plans)
Is this an amendment to an approved plan? Yes ® No ❑
Is this a revision or resubmission for review? Yes ❑ No El
County File Number-. WPO20210004
be provrded br the CounrvJbr new applieartons)
The following are required elements of new applications (from code section 17-401]. For revisions or
amendments, please indicate which items are being amended. Signatures must be provided for an.),
submission.
® A. Signature of the Owner for each parcel: (Required with every submission or revision, NOT TO BE
SIGNED BY AN AGENT OR CONSULTANT)
By signing this application as the owner, 1 hereby certify that all requirements of these plans and permits will he
complied with, and I have the authority to authorize the land disturbing activities and development on the subject
property. I hereby grant the County of Albemarle the right to enter upon the property as required to ensure
compliance with the approved plans and permits. 1 1 �9 n1
09000-00-00-001 AO Southwood Charlottesville LLC 4 11 A s,V 9/23/2022
090Al-00-00-001 EO Southwood Charlottesville LLC u r c�9/23/2022
Tax Map & Parcel Print Name of Owner ' Signature ot Owner Date
Tax Map & Parcel Print Name of Owner Signature of Owner Date
Tax Map & Parcel Print Name of Ossmer Signature of Owner Date
Contact Infonnation for the Owner(s) to receive correspondence
Print Name Andrew Vinisky
Address 967 2nd Street SE
City Charlottesville State VA lip 22902
Daytime Phone ( 571) 262-1615 E-mail avinisky@cvillehabitat.org
Revised 07/24/1 R Page 1 of 2
® B. All Fees [Code section 17-208]
For new or modified plans; Total acres proposed to be disturbed 7.97 AC
Acres to be
disturbed
Total Fcc
Fm Duc with this
Application
Fcc with Tmnsfcr or
modification of permit
Less than 1
$290
$145
$20
I and less than 5
$2,700
$1,350
$200
Sand less than 10
$3,400
$1,700
$250
10 and less than 50
$4,500
$2,250
$300
50 and less than
100
$6,100
$3,050
$450
100 and more
$9,600
$4,800
$700
For (minor) amendments to an approved plan: $200 per review
Variances; $150
Mitigation Plan; $150
❑ C. Registration Statement on the official DEQ form.
❑ D. Erosion and Sediment Control Plan satisfying the requirements of code section 17-402.
❑ E. Stormwater Management Plan satisfying the requirements of code section 17-403.
❑ F. Pollution Prevention Plan satisfying the requirements of code section 17-404.
❑ G. Stormwater Pollution Prevention Plan satisfying the requirements of code section 17-405.
❑ H. Mitigation Plan satisfying the requirements of code section 17-406 for any proposed disturbance of
stream buffers.
❑ 1. Requested Variations or Exceptions as provided in code sections 17-407 and 408.
❑ J. Construction Record Drawings (as-builts) for any existing facilities in the proposal satisfying the
requirements of code section 17-422.
Provide 2 copies of all Plans and any supporting documents. Professional seals must have original
signatures.
Additional information if not provided on plans and documents:
Name of a Contact Person for correspondence (usually the plan preparer, consultant or agent)
Print Name Timmons Group, Attn: Bryan Cichocki
Address 608 Preston Avenue Suite 200
Charlottesville
VA Zip 22903
Daytime Phone (434) 327-1690 Email bryan.cichocki@tlmmons.com
*when applications and plans are reviewed, but not approved, and a response to comments is not received within 6 months
from the date of county comments, the application will be deemed withdrawn. Applications without valid owner's
signatures will not be considered valid.
FOR OFFICE USE ONLY RTO N
Fee Amount $ Dale Paid ey who.' Receipt q Ckk By:
Revised 07/2411 R Page 2 of 2